Provider Demographics
NPI:1689182412
Name:SAVERITT PEDIATRICS PLLC
Entity Type:Organization
Organization Name:SAVERITT PEDIATRICS PLLC
Other - Org Name:BEST START PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:AVERITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-236-7974
Mailing Address - Street 1:2857 N DORCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3989
Mailing Address - Country:US
Mailing Address - Phone:479-236-7974
Mailing Address - Fax:
Practice Address - Street 1:5501 WILLOW CREEK DR STE 203
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-8708
Practice Address - Country:US
Practice Address - Phone:479-575-9359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-15
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE24592080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200016780AMedicaid
OK200016780AOtherSOONER PCP
MO1356304091Medicaid
OK1324230001OtherPALMETTO DME
OK731310891028OtherTRICARE SOUTH
OKH14901OtherSTERLING OPTION 1
AR140067001Medicaid
OK74502A050OtherCHAMPUS (WPS)